States and the New Federal Home Visiting Initiative
An Assessment from the Starting Line
For the purposes of creating an inventory of comparable programs, Pew defined “home visiting” as a voluntary, sustained effort that:
- Pairs new and expectant families with home visitors who provide parenting information and connections to community-based services and support during pregnancy and throughout early childhood;
- Delivers services primarily in the family’s home, although programs may complement home visits with socialization activities such as group classes and parent outings; and
- Is supported through state allocations (using either state or federal dollars).
Excluded from the survey were programs that employ home visiting as a strategy but do not fully satisfy the definition above, such as:
- Involuntary visits resulting from a child protective services investigation or a court order;
- Programs targeting children four or older, unless they are enrolled before the age of two;
- Programs that use home visiting as a component of a broader family support strategy but do not identify the home as the primary location for service delivery (such as Family Resource Centers or other primarily center-based initiatives;
- Home-based services delivered as required by the federal Individuals with Disabilities Education Act (IDEA);
- Federal funding allocated directly to localities and not state-administered, such as Healthy Start and Early Head Start; and
- Funding from private organizations and communities.
For the purposes of this inventory, a state home visiting “program” is defined as an initiative that:
- Is administered through state agencies—such as health and human services—that direct funding to local communities to support service delivery, articulate standards and regulations, set performance measures and provide oversight and infrastructure;
- Delivers services mainly in families’ homes, though visits may be complemented with socialization activities such as group classes and parent outings;
- Receives support through state allocations, using either state or federal dollars.
Healthy Families America
Healthy Families America (HFA) is designed to serve families at-risk for child abuse and neglect. The home visitor provides parent education and support, linkages to community resources and child development screenings. 
The Nurse-Family Partnership (NFP) provides home visitation services to low-income, first-time mothers by registered nurses beginning early in pregnancy and continuing through the child’s second year of life. The program targets a wide range of outcomes, with a focus on maternal and child health and family self-sufficiency. 
Parents as Teachers
Parents as Teachers (PAT) focuses on supporting a parent’s role in promoting school readiness and healthy development. PAT visitors provide information on children’s development, teach parents to encourage their child’s learning, provide referrals to community resources when needed and conduct screenings of children’s development, health, hearing and vision. 
The estimated number of children age 0-3 whose families live at or below 125 percent of poverty line. These estimates are derived from the Current Population Survey Table Creator and represent a three-year average between 2007 and 2009.